He said that there were multiple levels to the communication problem.

I felt that communication seemed to be better from the perfusion point of view, because if they didn't hear anything, they would pipe up, and they never took offense to my raising a question because I didn't hear. I didn't get the sense that other members of the team responded in that fashion. When I asked a question, I would get no answer, and it was viewed negatively and not as I just need to know what's going on and all you need to do is acknowledge. (Evidence, pages 25,066-25,067)

Odim said he felt communication with the perfusionists was better because "they seemed to have a better appreciation of the normal conduct in a cardiac operating room." (Evidence, page 25,067) On other levels, he said information on the clinical course of a patient's treatment was not communicated to every team member.

Odim also said that at times, some members of the team would interpret a question, such as "Have you turned the flow down?" as a challenge or a suggestion that the person being asked was remiss, as opposed to them being asked a simple question. As a result, he said, people might respond by saying, "Well, of course," as opposed to simply answering the question (Evidence, page 25,085). He also indicated that he had asked members of the team to be quiet. In addition, he spoke of difficulties in getting nurses in the intensive care unit to call him early in the morning to let him know how a patient had passed the night.